Individual Registration

Please fill in the form below to register for private Guiding Wales.

First Name *

Last Name *

Occupation

Age

Address *

Postcode *

Phone *

Email *

Name and number of a person to contact in an emergency *

Any special dietary requirements

Any medical conditions, allergies or disabilities

Any Awards or previous outdoor activity experience

Amount

Payment Method

Billing Zipcode*

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Type*

Card Holder Name*

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By registering for this course, I accept the Terms and Conditions

Anti spam*